title: Parents' decision making and access to preventive healthcare for young children: applying Andersen's Model.
abstract: OBJECTIVE
  Implementing preventive health care for young children provides the best chance of improving health and changing a child's life course. In Australia, despite government support for preventive health care, uptake of preventive services for young children is low. Using Andersen's behavioural model of health-care utilization, we aimed to understand how parents conceptualized their children's preventive health care and how this impacted on access to preventive health-care services.
  
  
  METHODS
  Semi-structured telephone interviews conducted between May and July 2011.
  
  
  METHODS
  Twenty-eight parents of children aged 3-5 years from three diverse socio-economic areas of Melbourne, Australia.
  
  
  RESULTS
  Thematic analysis showed parents' access to child preventive health care was determined by birth order of their child, cultural health beliefs, personal health practices, relationship with the health provider and the costs associated with health services. Parents with more than one child placed their own experience ahead of professional expertise, and their younger children were less likely to complete routine preventive health checks. Concerns around developmental delays required validation through family, friends and childcare organizations before presentation to health services.
  
  
  CONCLUSIONS
  To improve child preventive health requires increased flexibility of services, strengthening of inter-professional relationships and enhancement of parents' knowledge about the importance of preventive health in early childhood. Policies that encourage continuity of care and remove point of service costs will further reduce barriers to preventive care for young children. Recent reforms in Australia's primary health care and the expansion of child preventive health checks into general practice present a timely opportunity for this to occur.
authors.affiliation: Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, Vic., Australia.
authors.forename: Karyn E
authors.initials: KE
authors.lastname: Alexander
authors.affiliation: Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, Vic., Australia.
authors.forename: Bianca
authors.initials: B
authors.lastname: Brijnath
authors.affiliation: Department of General Practice, School of Primary Health Care, Monash University, Notting Hill, Vic., Australia.
authors.forename: Danielle
authors.initials: D
authors.lastname: Mazza
mesh_terms: D001315:Australia; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D016487:Parenting; D010290:Parents / Q000523:psychology; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data*; D011368:Professional-Family Relations
keywords: Andersen's theory; general practice; parents; preventive healthcare; qualitative research; young children